So you want to be a doctor....

The following is all opinion and experience and not based on evidence I have ascertained through literature search.  It is meant to be a general summary and is very over simplified.  As such, I am sure there are individuals will state that it wasn’t how their experience went.

The medical career has long been noted as a highly respected one and it takes a very long time to become a physician.  In my many teaching roles, I constantly have learners in different stages of learning and I often wonder how much patients know about the process and how much of a role they play in the education of future physicians.

The decision to become a physician is one that comes at many points in people’s lives.  Some know it as their calling and spend their life striving towards the goal.  For some, this goal is left unachieved and this can be quite heartbreaking.  One would hope that it leads to their true calling but other times, this can lead to regret, as it is not an easy road to travel.

The educational needs to get into medical school change as time goes on and I will leave it to perspective medical students to review with their guidance counsellors about current needs to enter medical school.

There is no one set path when people enter medical school, as I have met physicians who have come from many different backgrounds.

One path some students may decide to choose is:

Complete High School with excellent marks and volunteer experience (which has become somewhat diluted as most high school require proof of some type of volunteer experience)

Undergraduate studies are undertaken at University or College can be for 3 or 4 years and then students usually apply to medical school.

This can be a very nerve-racking time in their life as the medical school admissions are quite difficult to get, especially in Canada, given the fact that there are only 17 medical schools in Canada, of which 3 are french M.D. schools.

Current medical schools in Canada include (listed alphabetically):

Dalhousie University Faculty of Medicine – Halifax, Nova Scotia

Laval University Faculty of Medicine – Quebec City, Quebec

Northern OntarioSchool of Medicine – Thunderbay, Ontario (West) and Sudbury, Ontario (East)

McGill University Faculty of Medicine - Montréal, Quebec

McMaster University School of Medicine - Hamilton, Ontario

Memorial University of Newfoundland Faculty of Medicine – St. John’s, Newfoundland

Queen’s University Faculty of Health Sciences - Kingston, Ontario

The University of Western Ontario Faculty of Medicine and Dentistry - London, Ontario

Université de Montréal Faculty of Medicine - Montréal, Quebec

Université de Sherbrooke Faculty of Medicine - Sherbrooke, Quebec

University of Alberta Faculty of Medicine and Dentistry - Edmonton, Alberta

University of British Columbia Faculty of Medicine- Vancouver, British Columbia

University of Calgary Faculty of Medicine - Calgary, Alberta

University of Manitoba Faculty of Medicine - Winnipeg, Manitoba

University of Ottawa Faculty of Medicine - Ottawa, Ontario

University of Saskatchewan College of Medicine – Saskatoon, Saskatchewan

University of Toronto Faculty of Medicine – Toronto, Ontario (St. George Campus), Mississauga, Ontario (Mississauga Campus) and Scarborough, Ontario (Scarborough Campus)

Medical school is broken down into Pre-Clerkship years and Clerkship years.  Each school’s curriculum is slightly different, but the first two years (Pre-Clerkships) are usually more classroom based learning with significant amounts of memorization.  At this stage, acronyms is heavily used and usually the more lewd and crude they are, the longer they stick in the memory banks.  Very commonly, people remember the acronyms but not necessarily what they stand for.

One form of patient interaction that occurs at this point are “Standardized Patients.”  One could think of these patients as actors playing a role and the student has to figure out what the disease is that they are pretending to have.  Most schools will also have pre-clerkship students see hospital based patients as part of

Some schools present students with an opportunity to work with a Family Physician once or twice a week to gain an idea about what clerkships will be like and get a flavor of Family Medicine.

Students may get some clinical experience with specialists in their Pre-Clerkships, it is usually the Clerkships where patients encuter students.  The student history and physical is usually the most in depth and the common comment that most patients will make is “I’ve never had a doctor ask me to do that before.”  The reason is usually that it was a physical exam test that is rarely used by practicing attending physicians.  The level of knowledge is usually very broad with much information but not a great deal of organization, this causes students to feel that everything is important and that nothing should be left out.

Clerkships last two years and usually consist of “core” rotations (learning experiences that are specifically designated as mandatory) and “elective” rotations (learning experiences that the student will choose specifically for the sake of their own interest).

After the fourth year of medical school, students apply for residency.  This can be a very difficult decision, as it is the choice of their medical career.  This is very comically illustrated in the following image:

 Source:  Doccartoon.blogspot.ca

The final choice also determines how many years the training will take.  Many training programs are between 2-5 years at which point, residents will then sub-specialize into further training known as fellowships.  These can vary in length from 6 months-5 years.  The first year after medical school is commonly referred to as the internship year, and I find many patients can relate to this term, as many professions have internships or a probationary period.  This is not quite the same, but is helpful to put into perspective.

It is important for patients to realize that residents are physicians and do have M.D. after their name as they have completed medical schools, though are technically still in training.

Once someone has completed their residency or fellowship, they become an Attending Physician.  This means that they can practice independently, making all the important life and death decisions that need to be made.

It is easy to see that the level of training to become a fully fledged Attending Physician is not a simple road and requires significant amount of hard work and dedication.

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